Skin Care

Care of the skin is an integral part of overall care. The skin is the largest organ of the body. It is the immune system’s first line of defense against infection. 

• Healthy skin needs to be cleaned and well hydrated. 
• Wash with warm water and mild soap. 
• Avoid friction or rubbing. 
• Clean skin after each soiling. 
• Use alcohol-free lotions on dry skin for moisturizing. 
• Do not massage reddened areas. 

• Encourage the person to be out of bed as tolerated. 
• Avoid having the person sit up straight in bed longer than necessary. This puts pressure on the buttocks and sacrum. 
• Raise heels off the bed by placing pillows under calves and knees for support. 
• Change the bedbound person’s position at least every two hours; one hour if in a chair. 
• Remind the person to shift their weight, if possible, every 15 minutes. 
• Ask your team to show you how to use “draw” or “pull” sheets to move the person, avoiding friction from sheets. 
• Keep the person’s skin clean and dry. 

• Reddened areas that do not fade. 
• Open areas or blisters on the skin. 
• Any changes in the ability to turn or change the person’s position. If it becomes difficult for the person to change position because of weakness or pain. 

The team can advise you on special pads and mattress overlays to help prevent skin breakdown. Nutrition is essential, but sometimes food may overwhelm the sick person. Offer them protein-rich drinks and snacks during the day as tolerated. 

Even though attentive care is provided, skin can break down because of the physical changes at the end of life. Skin breakdown can result from lying in bed much of the time. Other medical issues may prevent or delay healing. It is important to report any changes, redness, or skin breakdown to the nurse. 

The person’s comfort is the goal of care.